氯膦酸二钠预防芳香化酶抑制剂引起骨丢失的临床观察  

Clinical Observation on the Efficacy of Disodium Clodronate in Preventing Bone Loss Induced by Aromatase Inhibitor in Breast Cancer

作　　者：文玲波[1] 杨兰平[1] 

机构地区：[1]柳州医学高等专科学校第二附属医院化疗科,广西柳州545006

出　　处：《中南医学科学杂志》2013年第2期171-173,共3页Medical Science Journal of Central South China

摘　　要：目的探讨氯膦酸二钠预防绝经后乳腺癌患者芳香化酶抑制剂内分泌治疗引起骨丢失的效果。方法 64例绝经后激素受体阳性乳腺癌患者,经本院伦理学委员会批准,回顾性分为治疗组(氯膦酸二钠与芳香化酶抑制剂连用)和对照组(单用芳香化酶抑制剂)。随访24个月,观察不同时期两组患者前臂远端桡骨+尺骨的骨密度,骨量减少和骨质疏松发生率的变化。结果治疗6个月,氯膦酸二钠组前臂远端桡骨+尺骨的骨密度与单用芳香化酶抑制剂组相比有增高趋势,但差异无显著性(P>0.05)。两组骨丢失事件的发生间差异无显著性(均P>0.05)。12个月时,治疗组骨密度较对照组明显升高(P<0.05),治疗组骨量减少和骨质疏松的发生率低于对照组(均P<0.05)。24个月时,治疗组的骨密度明显高于对照组(P<0.05)。治疗组骨量减少和骨质疏松的发生率明显低于对照组(均P<0.05)。治疗期间,除治疗组胃肠道反应发生率高于对照组外(P<0.05),两组其他不良反应的发生率相似(P>0.05)。结论氯膦酸二钠对芳香化酶抑制剂内分泌治疗引起的骨丢失有明显的预防作用,且不良反应轻微,安全有效。Objective To evaluate the efficacy of disodium clodronate in preventing bone loss induced by aromatase inhibitor in postmenopansal women with breast cancer. Methods A total of 64 postmenopausal breast cancer patients with positive hormone receptors were randomly divided into two groups. The disodium clodronate plus aromatase inhinitor group （the treat group）included 32 postmenopausal breast cancer patients. There were 32 patients in the aromatase inhibitor group （ the control group）. The forearm distal radius ＋ ulna bone mineral density （ Dist. R ＋ U BMD ） and the incidence of osteopenia and osteoporosis were compared between the two groups at different time points in 24 months. Results After 6 months, the treat group had a higher Dist. R ＋ U BMD than the control group, but the difference between them was not significant （P 〉 0. 05 ）. There was no significant difference in the incidence of osteopenia and osteoprosis between the two groups （ P 〉 0. 05 ）. At 12 months after treatment ,the treat group had higher Dist. R ＋ U BMD than the control group （ P 〈 0. 05 ） ;and the incidence of osteopenia and osteoporosis in the treat group was lower than that in the control group （ P 〈 0. 05 ）. At 24 months after treatment,the Dist. R ＋ U BMD in the treat group was higher than that in the control group （ P 〈 0. 05 ） ; and the incidence of osteopenia and osteoporosis in the treat group was lower than that in the control group （ P 〈 0. 05 ）. The incidence of adverse effects between the two groups was similar except for gastrointestinal reactions. Patients in the treat group had a higher rate of gastrointestinal reactions （ P 〈 0. 05 ）. Conclusion Disodium clodronate is effective for preventing bone loss induced by aromatase inhibitor in postmenopausal breast cancer patients,with slight adverse reactions.

关 键 词：乳腺癌 芳香化酶抑制剂 骨丢失 氯膦酸二钠 

分 类 号：R730.53[医药卫生—肿瘤]